In endoscopic examinations/procedures, flexible instruments are used to view a body lumen, such as the gastrointestinal tract and many others. The instruments are provided with fiber optic or charge-couple device (CCD) cameras which enable images to be transmitted around bends and images to be produced to displays on a screen.
For example, colonoscopic and enteroscopic examinations are the most effective techniques to assess the state of health of the bowel. However, they are inconvenient, uncomfortable, expensive procedures that are associated with significant risks of potentially serious complications. A further disadvantage is that they are time consuming for patients and medical personnel alike.
Four yet further additional significant difficulties associated with colonoscopy and scoping procedures more generally are as follows:
Firstly, the anatomy of the colon is such that the lining is thrown into folds. As the tip of the endoscope passes along the lumen of the colon, these folds hamper the endoscopist's ability to visualize the entire surface of the mucosa and in particular, detect pre-malignant and malignant lesions tucked away on the proximal face of these folds during extubation.
Secondly, the position of the tip may be difficult to maintain from the moment at which a lesion or polyp is detected to the completion of any therapeutic procedure. As the colonoscope is moving the tip does not travel back at a constant speed but rather with jerks and slippages particularly when traversing a bend or length of colon where the bowel has been concertinaed over the endoscope shaft during intubation. The tip of the device may, at any moment, slip backwards thereby causing the clinician to lose position. If tip position is lost, the clinician is required to relocate the lesion or polyp for the therapeutic procedure to be continued.
Thirdly, bowel tissue is flexible and may fall over the scope distal end, disturbing the camera view/video picture.
Fourthly, fecal and liquid remains may hide the colon walls, preventing proper examination of the colon tissue.
The colonoscopic procedure is not simple because the bowel is long and convoluted. In places it is tethered by peritoneal bands and in others it lies relatively free. When the tip of the endoscope encounters a tight bend the free part of the colon “loops” as more of the endoscope is introduced and causes difficulty to negotiate the bend.
PCT Patent Application WO 2011/148172 describes a sleeve for a medical scope distal section. The sleeve has a plurality of moveable, external, angled projecting elements having a tip and a base, which are moveable between a resting angled position to a position wherein the tip of the projecting element is substantially parallel to a longitudinal axis of the medical scope, and to a position that is at an angle approximately perpendicular to the longitudinal axis of the medical scope. The device is intended to close the projection elements while the medical scope is moving forward (distally), and open the projection elements during withdrawal of the medical scope (proximally), thereby to assist opening colon folds for better colon mucosa examination during scope withdrawal (only). Since bowel screening is not usually done in one withdrawal movement but in short movements backwards and forward, such projection elements may not reach a perpendicular position relative to the longitudinal axis of the medical scope.
PCT Patent Application WO00/13736 describes an apparatus for percutaneous insertion into the cardiovascular system. It includes a catheter or catheter guide having a distal end, and flexible, permanently extended, generally radial protrusions (e.g., thin flexible fins or radially spaced fins) situated adjacent the distal tip of the catheter.